Total Ankle Replacement Physical Therapy

Total Ankle Replacement Physical Therapy: After a total ankle replacement, you can rest assured that the physical therapists at Specialized Physical Therapy are confident in their ability to restore you to your prior function.


Common symptoms leading to a total ankle replacement include ankle pain, stiffness, or grinding within the ankle joint typically due to arthritis. After a total ankle replacement, it is typical to have some pain, stiffness, and swelling. However, be mindful of pain in the calf, severe swelling, redness, and/or warmth. If you notice these symptoms, seek medical attention immediately.

Following total ankle replacement surgery, it is not uncommon to have some decreased sensation and discoloration around the surgical incisions. Wearing the surgical boot or a cast can also place greater strain and pressure on the knees and hips occasionally causing soreness to those joints when walking, standing, and performing other ADL’s (activities of daily living).

Total Ankle Replacement Causes

Total ankle replacements are usually due to severe arthritis within the joint, but often times traumatic injuries can lead to severe arthritis as well. During an ankle replacement surgery, the damaged cartilage surfaces at end of the tibia (shin bone) and the top of the tibia (bone that sits under the shin bone to create one of the main ankle joints) are shaved down and replaced with metal implants. A spacer is then placed between the two metal implants to allow easy movement at the joint.

Total Ankle Replacement Diagnosis

Your physical therapist will first take a history of your symptoms, including questions to understand your pain pattern, history of symptoms, how your symptoms affect your function throughout the day, and your goals. Next, your therapist will perform a thorough examination of your ankle mobility, strength, muscle flexibility, scar healing and skin integrity. Performing a comprehensive evaluation following a total ankle replacement will help the therapist to understand the cause of the symptoms and how to treat it with the right total ankle replacement physical therapy program.

Total Ankle Replacement Treatment and Exercises

After careful examination, your physical therapist will create a personalized program to create a program aimed to reach your goals with physical therapy exercises after total ankle replacement. The total ankle replacement physical therapy program will involve manual therapy and exercises to safely improve the flexibility and mobility of your shoulder, improve strength of the surrounding muscles, reduce pain, and teach you ways to manage the symptoms so you can get back to doing what you love.

Typically total ankle replacement physical therapy starts approximately 4-6 weeks after surgery. A short leg cast or walking boot (CAM) boot is usually removed and discharged form use at that time as well. The initial focus is on reducing pain and inflammation, increasing active range of motion, and then strengthening the ankle to allow for activities of daily living. Moving the ankle forward and backwards (ankle dorsiflexion and plantarflexion) are the most important movements to initially focus on. These movements will allow for greater ease of walking, transfers, and increase independence for activities of daily living (ADL’s).

Once the maximum active range of motion is achieved through total ankle replacement physical therapy, higher level strength and balance exercises are performed. Squats, single limp stance, balance beam, hurdles, and utilizing an agility ladder are all incorporated into the treatment plan. Utilizing the Neubie Neufit system to accelerate the healing process and increase strength faster allows the patient to return to their sports and other activities faster.

Request a free consultation or give us a call to get started with total ankle replacement physical therapy! Be sure to check out our other physical therapy services if you choose to refer Specialized Physical Therapy to a friend or loved one.

Request a free consultation or give us a call to get started!